Healthcare Provider Details

I. General information

NPI: 1427284264
Provider Name (Legal Business Name): EARLY EDUCATION SERVICES OF WINDHAM COUNTY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2009
Last Update Date: 06/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 BIRGE ST
BRATTLEBORO VT
05301-6460
US

IV. Provider business mailing address

130 BIRGE ST
BRATTLEBORO VT
05301-6460
US

V. Phone/Fax

Practice location:
  • Phone: 802-254-3742
  • Fax: 802-254-3750
Mailing address:
  • Phone: 802-254-3742
  • Fax: 802-254-3750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MS. DEBRA J GASS
Title or Position: DIRECTOR
Credential:
Phone: 802-254-3742